Study Flags 24 High-Risk Prescribing Cascades in Older Adults
Ontario researchers analyzing more than 2.2 million adults aged 66+ found that 24 of 65 potentially inappropriate prescribing cascades (PIPCs) have high prevalence, incidence, and temporal linkage. Common patterns include NSAIDs raising blood pressure and prompting antihypertensives, iron-with-laxatives, statins-with-pain relievers, and cholinesterase inhibitors-with-sleep meds, with strongest timing links for corticosteroids→antipsychotics, laxatives→antidiarrheals, and cholinesterase inhibitors→antiemetics. The study suggests clinician/pharmacist alerts and better documentation to prevent cascades, while noting that temporal associations do not prove causation and patient context matters through shared decision‑making.